Type 2 Diabetes
Type 2 diabetes is a lifelong condition to manage, and for some people intensive weight loss can bring blood sugar into a normal range without medication for a period of time. Doctors call this state remission: a deliberately careful word, not a sign that follow-up can stop.
Medically reviewed by the RIIMS medical team · Last updated: June 2026
Go to hospital now
- Confusion, drowsiness or difficulty waking someone with diabetes
- Fruity-smelling breath with vomiting and rapid breathing (possible diabetic ketoacidosis)
- A blood sugar reading below 70 mg/dL that does not improve after taking sugar
- Chest pain or breathlessness
See a doctor soon (not an emergency)
- Blood sugar consistently above your target range despite taking medicine as advised
- A foot wound, numbness or a new ulcer
- Blurred vision that is new or worsening
What does a diagnosis of type 2 diabetes mean, and what is remission?
Type 2 diabetes means the body does not use insulin effectively, or does not make enough of it, so blood sugar runs higher than it should. It typically develops over years and often has no early symptoms, which is why routine screening matters as much as symptoms do. In 2021 an international panel convened by the American Diabetes Association and the European Association for the Study of Diabetes agreed on a precise definition of remission: HbA1c below 6.5% sustained for at least three months after completely stopping all glucose-lowering medication. The panel deliberately chose remission over a more absolute-sounding term, because implying the condition was gone for good would wrongly suggest that follow-up is no longer needed. Even in remission, the same yearly checks continue: eye screening, kidney tests, foot checks and an annual HbA1c, because the underlying tendency towards high blood sugar does not disappear. The strongest evidence for remission comes from the DiRECT trial in Scotland, where a structured weight-management programme put 46% of participants into remission at one year, falling to 36% at two years and 13% by five years. DiRECT enrolled people who had lived with diabetes for six years or less, were not on insulin, and were of Scottish background; whether the same results apply to Asian Indians, who tend to develop diabetes at a lower body weight and after fewer years of excess weight, has not been established. What weight loss reliably improves, whether or not full remission is reached, is blood sugar control, blood pressure and the medicine burden.
Symptoms to watch for
- Increased thirst and frequent urination
- Unexplained tiredness
- Slow-healing cuts or frequent infections
- Blurred vision
- Tingling or numbness in the feet
- Often no symptoms at all in the early years
When to consult a doctor
A fasting sugar, HbA1c or random blood sugar test confirms the diagnosis. Do not wait for symptoms if you have risk factors such as family history, high BMI or a large waist. Contact your doctor promptly for very high or very low readings, or for the emergency signs below.